Validation of clinical frailty scale in Chinese translation

Yi-Chun Chou; Hsiao-Hui Tsou; Ding-Cheng Derrick Chan; Chiung-Jung Wen; Feng-Ping Lu; Kun-Pei Lin; Meng-Chen Wu; Yung-Ming Chen; Jen-Hau Chen

doi:10.1186/s12877-022-03287-x

Validation of clinical frailty scale in Chinese translation

BMC Geriatr. 2022 Jul 20;22(1):604. doi: 10.1186/s12877-022-03287-x.

Authors

Yi-Chun Chou¹, Hsiao-Hui Tsou², Ding-Cheng Derrick Chan^{1

3}, Chiung-Jung Wen^{1

4}, Feng-Ping Lu^{1

3}, Kun-Pei Lin^{1

3}, Meng-Chen Wu^{1

5}, Yung-Ming Chen^{3

6}, Jen-Hau Chen^{7

8}

Affiliations

¹ Department of Geriatrics and Gerontology, National Taiwan University Hospital, No.7, Chung Shan South Road, Taipei, 100, Taiwan.
² Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County, 350, Taiwan.
³ Department of Internal Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei, 100, Taiwan.
⁴ Department of Family Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei, 100, Taiwan.
⁵ Department of Neurology, National Taiwan University Hospital, No.7, Chung Shan South Road, Taipei, 100, Taiwan.
⁶ Superintendent Office, National Taiwan University Hospital Bei-Hu Branch, No. 87, Neijiang Street, Taipei, 108, Taiwan.
⁷ Department of Geriatrics and Gerontology, National Taiwan University Hospital, No.7, Chung Shan South Road, Taipei, 100, Taiwan. jhhchen@ntu.edu.tw.
⁸ Department of Internal Medicine, College of Medicine, National Taiwan University, No.1, Jen Ai Road Section 1, Taipei, 100, Taiwan. jhhchen@ntu.edu.tw.

Abstract

Background: Identification of frailty is crucial to guide patient care for the elderly. The Clinical Frailty Scale (CFS) is a reliable, synthesis and clinical judgment-based tool. However, a validated Chinese version of CFS (CFS-C) is lacking. The aim of this study is to describe the translation process of CFS into traditional Chinese and to evaluate its reliability and validity in a geriatric study population in Taiwan.

Methods: This cross-sectional study recruited 221 geriatric outpatients aged 65 years or older at a medical center in Taipei, Taiwan. The Chinese version of CFS was produced following Brislin's translation model. Weighted kappa for agreement and Kendall's tau for correlation were used to assess inter-rater reliability (a subgroup of 52 outpatients) between geriatricians and one research assistant, and validity tests (221 outpatients) by comparing CFS-C with Fried frailty phenotype and Frailty Index based on Comprehensive Geriatric Assessment (FI-CGA). Correlation between CFS-C and other geriatric conditions were also assessed.

Results: The inter-rater reliability revealed moderate agreement (weighted kappa = 0.60) and strong correlation (Kendall's tau = 0.67). For criterion validity, CFS-C categorisation showed fair agreement (weighted kappa = 0.37) and significant correlation (Kendall's tau = 0.46) with Fried frailty phenotype, and higher agreement (weighted kappa = 0.51) and correlation (Kendall's tau = 0.63) with FI-CGA categorisation. CFS-C was significantly correlated with various geriatric assessments, including functional disability, physical performance, hand grip, comorbidity, cognition, depression, and nutrition status. No significant correlation was found between CFS-C and appendicular muscle mass.

Conclusions: The CFS-C demonstrated acceptable validity and reliability in Chinese older adults in Taiwan. Development of CFS-C enhanced consistency and accuracy of frailty assessment, both in research and clinical practice.

Keywords: Clinical frailty scale; Elderly; Frailty; Validation studies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
China
Cross-Sectional Studies
Frail Elderly
Frailty* / diagnosis
Frailty* / epidemiology
Geriatric Assessment
Hand Strength
Humans
Reproducibility of Results